In Reply: In response to Mr Freeny, PST-PC
is a promising, behaviorally based, psychological treatment developed specifically
for primary care. In 1 randomized trial, it was superior to placebo for major
depression.1 In another trial, PST delivered
by telephone showed clinically important effects.2
We built on previous studies by evaluating the effectiveness of PST-PC in
patients with minor depression or dysthymia, using a relatively limited, but
feasible dose for primary care (6 sessions). We agree that PST-PC is best
categorized as a psychological treatment, not psychotherapy, and that the
dose may have been too low for patients with dysthymia. In an ongoing study,
we are evaluating the effect of more sessions of PST-PC. Until more definitive
data are available, we consider it a psychological treatment in development.